For the truly poor, being institutionally forced to take welfare is demoralizing. The Affordable Care Act is at risk of systematizing learned helplessness by telling individuals like my mother that they cannot afford to care for themselves in the way they could before the law was enacted. "This makes me feel poorer than ever," she said.

My mother grew up, one of six children, in a dairy-farming family in Wisconsin. "The way I was raised, taking government handouts is shameful," she said. Her siblings stayed in Wisconsin, but she set out on her own. Finding herself forced onto Medicaid is not a fate that she ever would have imagined. "I guarantee I'm the only person in my family in this situation."

I'm proud to see the spiritedness and resolve that bears my mother up even now. Such character does not draw attention to itself: Its spark only catches the eye when oppression seeks to snuff it out.